出院病患居家首月所面臨健康照護問題之探討

The Problems of Family Caregiving among Discharged Patients in First Month

陳滋茨(Zei-Tei Chen) ； 林艷君(Yen-Chun Lin) ； 戴玉慈(Yu-Tzu Dai)

《護理研究》 7卷5期 (1999/10) Pp. 423-434

https://doi.org/10.7081/NR.199910.0423

摘要

本研究的目的在探討出院病患對服務的滿意度、家庭照護能力以及居家所面臨健康照護問題，樣本來自臺北市某醫學中心的七個病房，於個案出院後一週及一個月後均進行一次電話追蹤訪問，自85年6月起至86年6月底止，共收案189名。結果發現：約九成的病患出院後返家，由家人照顧。約九成的主要照顧者執行照顧的能力為「中等或強」，有97.2%的人認爲出院後適應情況爲「尚可或很好」，89.7%的人對整體服務感到「滿意或非常滿意」。居家所面臨的健康照護問題，包括生理方面（出現不適症狀、日常活勤受限制、傷口與各種導管的照顧問題、病情監控與復診安排不易）、健康照護之訊息來源不足（疾病控制概念訊息不足、藥物相關知識訊息不足、與疾病有關的生活適應訊息不足、如何運用社且資源的訊息不足）及社合心理方面（情緒壓力大、面臨經濟困境）。大多數的問題在第一次追從時發現，在第二次追蹤時都有減少的趨勢。因此，醫療團隊應不斷修正其出院規劃，與社區維持良好的溝通與轉介管道，持續追踨與指導，以增強病人自我照顧能力，以提昇病人生活品質。

關鍵字

出院病患 ； 居家所面臨健康照護問題

並列摘要

The purposes of this study were to understand the level of satisfaction with services, family competence in caregiving and the problems of family caregiving among discharged patients. The subjects were 189 discharged patients from seven wards in a medical center. All of the subjects were interviewed by the researchers by telephone. They were called in the 1st week and 4th week after discharge. The results showed that 90% of subjects resided at home and were cared for by their families. About 90% of the caregivers had fair or good competence in caregiving. 97.2% of the patients’ level of adjustment was fair or good. 89.7% of the subjects’ level of satisfaction with services was good or very good. The problems of family caregiving included: physical problems (uncomfortable signs and symptoms, limitations of the activities of daily living, difficulties in tube and/or wound care, difficulties in monitoring the disease and arranging outpatient appointments), insufficient information about health care (disease control, medication related issues, strategies for living adjustment, utilization of social resources) and psychosocial problems (psychological distress, economic problems). Interventions during the first telephone calls were implemented, and the problems were decreased during the second calls. Therefore, members of the multidisciplinary health care team should modify discharge planning, maintain good coordination and referral channels within the community, give good guidance and support to patients, and increase the competence of caregiving, in order to improve the quality of patients’ life.

並列關鍵字

discharged patients ； problems of family caregiving